RelaxeyIn-Home Massage Inquiry And Booking Form
Please call 800-834-8350 or fill out the form below to book a session now.
Your Name: Please Digitally Sign by Entering Your Initials Here: E-Mail Address: Cell Phone Number: Is this your first time booking with Relaxey? Yes No Are you booking a session for TODAY? Yes No If not, what's the date of the session you're interested in: Time of session: Duration: One Hour 90 Minutes Two Hours
Is this a couples massage or massage for an individual? one therapist for one person two therapists for two people (couples massage) two therapists for one person (4-hand) If you are requesting a specific therapist by name please enter the therapist's name here: All our therapists are competent and among the top in the field. As Health Care Providers, we feel that gender is irrelevant. However, if you have a preference, please let us know. We wish to accommodate you, not impose our worldview. any gender would be fine female(s) would be preferred, but not mandatory Male(s) would be preferred, but not mandatory female(s) only male(s) only one male and one female preferred. send a Martian; I could care less. If they're a great therapist, it's A-OK. What is the gender of the person(s) receiving a massage? Female(s) Male(s) Male and Female
What region? NYC NJ CT Hamptons House Number and Street Name where the session will take place: Town or City: Neighborhood or Development: Type of residence: Private Home Townhouse Condo Multi-Unit Building Hotel What floor will the session take place on? What is the apartment or unit number or designation?
If there are special parking procedures, please state here: Is there an elevator? No Yes If the session is for someone other than yourself, please state the person's name and your connection with them.
Modalities you're interested in: (Please check ALL that may apply; multiple modalities may be combined in one session at no added cost, with the exception of Hot Stone.)
Swedish Massage
Harder Pressure Swedish Massage
Shiatsu
Postnatal Massage
Deep Tissue
Craniosacral Therapy
Myofascial Technique
Prenatal Massage
Sport Massage
Anything else you'd like us to know to be prepared for your session? Include it here! Would you like to pay now by credit card? Yes No
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